We Just Don't Talk about It: Alcohol and Other Drug and HIV Needs Assessment in Urban Mexican American Indian Communities

According to the recent U.S. census, more Hispanics are identifying as American Indian than ever before. The population of people of Indigenous heritage of North and South America - who also identify as Hispanic has tripled since 2000 going from 400,000 to 1.2 million nationally. Though this population at present represents only 1.4% of the overall Hispanic population, it is also the fastest growing sub-group in the fastest growing minority group in the United States. Changes to tribal groupings since the 2000 Census have revealed more diversity amongst those indigenous peoples previously identified broadly as “Latin American Indians”. A recent US Census Brief (2012) documents Mexican American Indians (MAI) as the 4^th largest tribal grouping in the United States, representing the emergence of a previously invisible indigenous group.

This raises important questions about the presence of unique HIV/AIDS health risk and protective factors given experiences associated with intersecting racial and cultural identities as both Mexican and American Indian. According to Sanchez and colleagues (2004), although previous HIV rates in Mexico and in Mexican Immigrants in California were relatively low, recent data suggests that the disease may increase more aggressively due to migration-related factors including constant mobility; cultural, linguistic and geographic barriers to health care services; a change in sexual practices; limited education; psychosocial factors; isolation; discrimination; poverty; chronic underemployment; and substandard housing. Lack of empirical data specifically on MAI and paradoxical outcomes within communities who may fall within the MAI population suggests that more research is needed on communities with experiences of bi-national migration, colonization, displacement and ongoing socio-structural inequality.

Methods:

Guided by the Indigenist Stress-Coping Model and using community-based participatory research (CBPR) approach, this team developed and conducted the first alcohol and other drug use (AOD) and HIV risk needs assessment of urban Mexican American Indian adults in the Pacific Northwest. The needs assessment provides valuable information about community-driven questions regarding AOD and HIV risk and protective factors related to unique race, culture, and migration experiences in the urban MAI community of the Pacific Northwest and is a first step toward developing culturally relevant and sustainable AOD and HIV interventions targeting this population. This project provides pilot data documenting needs and strengths and will build a platform for extramural funding for future comprehensive social epidemiological research within MAI communities of the Pacific Northwest and beyond.

Results:

The paper will provide an overview of preliminary results related to HIV prevalence, alcohol and other drug use prevalence and associated needs in the MAI community. Additionally, related themes of suicide and suicide risk, and silence and stigma related to health and mental health issues will be discussed.

Conclusion and Implications:

The long-term goal of this project is to develop a blueprint for understanding HIV prevention and treatment needs, risks, and protective factors for indigenous populations with complex racial, cultural, and migration experiences. It will also contribute to developing culturally relevant effective prevention and treatment approaches for the MAI community to reduce AOD and HIV disparities and promote overall community health and wellness.